Eight o’clock Monday morning, my phone alarm pinged at me repeatedly, while I tried to divest myself of the duvet, grunting in annoyance. Unless I had a meeting with my diss supervisor, I wasn’t even in uni on a Monday this year, and I was sure I’d remembered to turn the thing off.
Ah, but that wasn’t my alarm. It was a calendar reminder. I squinted at the screen and threw my phone down in dismay.
“Crap.” Weight management clinic. Sod’s law that was today, after a brilliant Saturday night and the utter bliss of Sunday kisses in the rain. I’d planned to sleep in and have a bath, which I never did because…OK, I was fairly sure the floor wasn’t going to fall through, but there was always that niggling doubt. But it had dwindled to bearable in the afterglow of spending the weekend with Leigh. So, a bath, then I’d planned to vacuum for Mum—or not for Mum, as it was my mess, too, but she usually did it before I thought to, being a mother and all. Then I was going to chill out on my bed—music, studying, chat to Leigh and Noah online… awesome day, happy Jesse.
But that was not to be.
It was nearly two years ago that I’d gone to my GP in a state of desperation, although I need to backtrack a little further. Three years ago, I’d slipped on wet leaves and badly twisted my knee. The X-ray showed nothing, and the doctor at the hospital concluded it was soft tissue damage. Rest, take ibuprofen, and ‘losing some weight will help’. I bloody know, thanks. Don’t they think it’s ever occurred to me? Oh, hey, you fell and twisted your knee. You know if you weren’t morbidly obese, you probably wouldn’t have slipped. I’d lost count of how many times people had said stuff like that to me in the past.
I’ve got a really bad toothache.
– Serves you right for eating all that chocolate.
My hay fever’s bad this year.
– That doesn’t mean you can’t exercise.
I burnt my hand on the oven.
– In a hurry to get the pizza out, were you?
Back to the knee…
By January, there had been no change, so I went to my GP, who basically ran an action replay of what the hospital had said. My weight was putting extra strain on the weakened joint, and if I wanted it to get better…on and on it went. Or it would’ve done if my mum hadn’t exploded with rage in the waiting room. I was embarrassed and proud all at once, but then, my mum knew my battle, because it was hers, too.
Next stop: a new GP, and she was a million times better from the get-go. No wisecracks about my weight, or interrogation of what I’d done to address it; she gave me a full check-up and sent an urgent referral for physiotherapy for my knee, and the appointment came through really quickly, which was great. Not so great was the advice I got with my knee exercises. If you lost a bit of weight, maybe cut back on…
The exercises did help a bit, but it was still swollen and painful, and it seized if I walked for more than ten minutes. I went back to my GP, and this time, I thought…that’s it. I can’t do this on my own. I asked for help, fully expecting the usual ‘here’s a high-fibre, low-calorie, impossible-to-stick-to diet sheet and exercise regime’. I was so done with those.
“I could refer you to the weight management clinic,” she suggested.
“What’s that?”
“They monitor your weight, give you realistic advice about healthy eating and exercise, talk through the available treatments.”
It sounded doable.
“There’s a waiting list, though.”
“How long?”
“Six months.”
“I’ll have a think about it.” It was too long, not because I was impatient, but…I don’t know. It felt like cheating, and maybe I could have another try? After all, what was a few more months when I’d been Big Jesse for nineteen years already? OK, that wasn’t strictly true. I’d been a normal-sized baby, but for all of my life that I could remember, I’d been chubby, carrying puppy fat, big for my age, overweight, obese, a little on the tubby side, or simply…fat.
“Matty, will you write me up a diet and exercise programme?” He hadn’t looked happy when I’d asked him, but he knew this stuff. He studied it as part of his degree.
“Sure. What exercise do you enjoy?”
Stumped. None of it? Eventually, I offered, “Swimming, but…” Nope. I wasn’t baring my flab for anyone.
“OK, so you’re not an exercise person. That’s all right. You just need to control your calorie intake.”
Wasn’t that what I’d already been doing?
He continued, “Like…three hundred calories less a day. That’ll give you slow, steady weight loss. Just drop two slices of bread.”
“That all?” I doubted it were that simple.
Matty had loaded an app on his phone, keyed in my height and a guess at my weight, which was close enough for rock and roll, and I wasn’t telling. “Yeah, look.” He’d shown me the info onscreen. “2,400 to maintain your current weight, 2,096 to lose weight.”
“How many?!” If I’d eaten that many calories a day, I’d have been the size of a house. I told Matty as much. His expression called me a liar, and he refused to play any part in my ‘starvation diets’ from that point on.
I tried. I had to record everything I ate, and discovered it’s surprisingly easy to tot up 2,000 calories over the course of a day. But I hated having to think about it. It was just so exhausting and boring. Why couldn’t I be like normal people and eat when I was hungry, stop when I’d had enough?
And my knee was still busted. So…I grabbed the bull by the horns: I went back to my GP.
“Sign me up,” I said.
My appointment came through a couple of months later, for a couple of months after that. Finally, there was my chance to get specialist help….except going to the clinic was more stressful than it was helpful.
Today was my fourth appointment, and in the year I’d been going, I’d lost a grand total of…zero kilos! Actually, that was a lie; I’d lost six and put them back on, but the weight management clinic was not taking any of the credit for that.
I didn’t feel like I’d achieved anything, but still. I was feeling upbeat. It was a Fat Pride day, and I was tempted to call and cancel the appointment whilst at the same time realising that tomorrow I might not feel so good about myself.
I fished out the appointment letter, noted the warning that if I didn’t turn up, the clinic would cancel my referral and I’d have to go back to my GP and start over. I was going, whether I liked it or not. My appointment wasn’t until ten-thirty, but for whatever reason—I guessed there wasn’t a clinic closer—it was thirty miles and an hour away on the bus, so I needed to get a move on.
Between my alarm, the rushed shower and the stress of finding out bus times, my good mood was well gone by the time I reached the kitchen, where my mum had made me a cup of tea and held the bread up to ask if I wanted toast. I shook my head.
“No, thanks, Mum. Not hungry.”
She raised an eyebrow but didn’t challenge me on it. “You’re not at college today, are you?”
I refrained from correcting her, because she was almost right. “No, I’m not.”
“A study day or a day off?”
“Weight management clinic.” I sighed into my tea and watched the ripples dissipate.
“Oh.” She rubbed my back. “Do you want me to come with you?”
That made me smile. She offered every time, still not used to me being an adult who could talk to doctors, dentists and opticians on my own, although maybe a dose of my mum’s fury would put a rocket up the arses of the dieticians at the clinic and they might actually do more than ask me if I’d been eating healthily. Seriously, they must be one of the most-lied-to professionals in the NHS.
“Are you sure you don’t want some toast?”
“Positive.” I tried to glug my tea, but it was still too hot, and even though the bus wasn’t for another forty minutes, I needed to get out of there. With one last mouthful, I tipped the rest of my tea down the edge of the sink so it didn’t make a splash, and gave my mum a quick hug. “See you later. Have a good day.”
“You, too, love. Good luck.”
I was gonna need it.
***
So…the bus was late. Great start. I reached the clinic at twenty to eleven, out of breath, sweating and without my letter, which I thought was probably still on my bed, along with my phone.
“I’ll see if they can fit you in,” the receptionist said, once she’d found my details on the computer. “Take a seat, please.”
“Thanks,” I puffed out and walked over to the chairs. The super-narrow chairs in the super-crowded waiting room. It was definitely a punitive system. Surely, given the kind of clinic it was, they’d know most of their patients weren’t going to fit into chairs that were both too small and too close together? Then there was the eternal waiting, which was bad enough on a normal day, when I wasn’t receiving extra punishment for turning up late and I had something to fill the wait with.
There were only two free chairs, in the middles of rows, so I picked up a magazine from the end of the counter and went to stand against the wall. Oh, yeah, and didn’t I pick the perfect thing to while away the however long I’d be there? Celebrity gossip, stick-thin celebrities, beach bodies, muscles and tan. Thanks so much, National Health Service, for constantly shoving it down my throat.
I put the magazine back, glancing over the rest of the offerings—healthy living, sport and fitness, more celebrity gossip—and gave up. Thirsty from sacrificing my morning cuppa and then rushing to get here, I wandered over to the vending machine—no bottles of water—and miserably returned to my previous standing space. This was gonna be one loooong morning.
People came; people went. Even people who arrived after me, although some of them had kids with them, and this was bad enough without, so I didn’t mind too much. I watched the waiting room pour scorn on a particularly big guy who hobbled in on crutches, coughing his guts up. See, it wasn’t just our average-sized healthcare professionals casting judgements; we were as bad ourselves. The guy booked in at the desk, looked around for a seat, as I’d done, and came over to where I was standing.
“Alright?” he wheezed.
“Yeah, you?”
“So-so.” He stood next to me and leaned a crutch against the wall, coughing again and then smiling apologetically. “It’s a hell of a way from the car park,” he explained.
“Is it?”
“Yeah. They don’t care about that, though, do they? It’s all exercise, eh?”
I’d have laughed at his sarcasm, but this whole situation was just too damn awful to be funny.
It wasn’t long after that my name was called, and I headed for the next step of my quarterly torture: onto the weighing chair, which was enormous, then the contraption for measuring height, with the mandatory, “You’re a tall one, aren’t you?” while they stretched up and lowered the measuring stick onto my head, followed by blood pressure and then, “All done.”
They never, ever volunteered the information, and today I was glad, because I didn’t want to know. Or I didn’t want to know enough to go to the effort of bracing myself for the bad news and asking the question.
“If you can wait outside, the dieticians will call you shortly, Jesse.”
“OK, thanks.” Back out I went, to the chairs along the corridor, opposite the dieticians’ room. At least there was a bit more space.
I didn’t bother looking at the magazines. Instead, I tried to plan my Discourse Analysis essay in my head, hoping I’d recalled the question correctly. Actually, I couldn’t recall the question at all, but the gist was discussing whether contemporary language innovation subverted or maintained hegemonic discourse. I was planning to compare the language standardisation of the industrial revolution to the impact of information technology, but I needed more focus, and…my thoughts had bored me into a stupor already. I seriously couldn’t do this in a hospital corridor.
“Jesse Thomas?”
Without looking, because I knew the drill, I got up and trudged after yet another dietician I’d never met before. It didn’t matter, as they all did the same thing: read my notes, asked me questions, and told me things I already knew, like…
“It’s a one-year wait for gastric surgery. Now, the most common treatment is the gastric band…”
To which, I always said, and today was no exception, “I don’t want surgery.”
“It still requires a change in lifestyle. Surgery on its own doesn’t—”
“I don’t want it.”
“OK.”
For Christ’s sake, why? I mean, I got why. They’d told me already; most people signed up to weight management with the hope of a miracle cure for their obesity, believing surgery was the answer. I was a third-year undergraduate student; I knew how to research for myself, so even if I’d believed that at the start, I knew that almost half the people who had gastric surgery ended up as fat, if not fatter than they were before.
You could cheat gastric bands—melt chocolate, eat ice cream, or liquidise burgers and pizzas, probably—and a sleeve didn’t stop your stomach from stretching to compensate for its decreased size. Gastric bypass meant taking supplements for the rest of your life. I knew all this. Twenty-one years old, and I was a professional dieter. Hell, I could’ve taught people what they needed to do to lose weight, but knowing and doing it were two very different things.
“What help do you feel you need from us, Jesse?”
Head-desk, head-desk, head-desk. “I…don’t know.” To lose weight? To keep the weight off? To find a way to stop feeling like a loser in every way but the one way I want to be?
“Well, your weight’s stable, which is positive.”
“Good.” Stable, but still too heavy.
“And your blood pressure is fine—a little on the high side.”
Yep, because this is the most stressful place on Earth!
“You know, if you cut out one snack a day, that would probably be all you need to do to see some steady weight loss.”
“Yes.” I nodded and smiled and refused to say anything else. I didn’t snack. I either stuffed my face or starved myself, so snacking would undoubtedly be a move in the right direction, not that the dieticians would see it that way. Unless I snacked on tiny raisins or something.
“If you get peckish between meals, try switching to healthy snacks. A handful of cereal with a few raisins…”
There we go.
“…unsalted nuts, seeds. Rice cakes with low-fat cream cheese, maybe.”
Like sawdust and PVA glue.
“Are you eating plenty of fibre?”
“Yes.”
“And you’re drinking plenty of water?”
“Yes.”
“What about sugar in hot drinks? Have you cut it out?”
“Yes.” I clamped my teeth together to stop the scream escaping. I’d done it all, and more, and told them every single time I’d come here.
“I understand your frustration, Jesse.”
Do you really?
“If you’re doing all these things, you should be losing weight. Did you get an information pack last time you came?”
“Yes.” And the time before, and the time before that…
“Would you like to take one, just in case?”
“No, it’s OK. I’ve got one, thank you.” Three, in fact.
“All right, then. Is there anything else?”
“No, thanks.”
She handed over my appointment sheet—“If you take this back to the reception desk, they’ll book your next appointment”—and I was outta there.
I didn’t bother with the reception desk. Two hours in that hellhole had obliterated every good feeling I’d stored up over the weekend. I caught the bus, holding off, holding off, until I got home, grateful Mum was at work. I grabbed a bottle of water from the fridge, went to my room. And cried.
* * * * *